Itchy pets 101 (Part 3: Treatment)

Treating itchy pets usually comes down to getting the right diagnosis for what ails them. We’ve already established that in parts 1 and 2 of this three-part series on the subject of itchiness (pruritus). Next up, my job is to tell you how we get them comfortable again. 

Fleas: Got bugs? Let’s get ‘em. Lots of products are aimed at flea-killing. The most popular veterinary-only products are usually your safest bet. And safe is what it’s all about. These are poisons, after all. So give your vet a chance to weigh in on what’s the safest option for your pet.

Mange: So much mange, so little time. But these mites don’t always need strong, mite-killing oral medicine or toxic dips (though more severe cases often do). Sometimes, antibiotics, antifungals, shampoos and topical creams can be more than enough. 

Hormonal disorders: These get treated based on the hormonal imbalance––whether it’s a depletion (for which they may receive supplements) or an excess (for which treatment varies and depends on the hormone and/or the organ(s) responsible for producing it). 

Superficial bacterial and/or fungal infections: Antibiotics and antifungals to conquer these infections come in a multitude of forms. Pills, sprays, flushes, drops, shampoos, conditioners, creams, wipes, sponge-ons, etc. 

Whether it’s the underlying cause or secondary to allergies or other troubles, we almost always treat infections separately. After all, these infections are responsible for much of the itchiness as well. 

Allergies: The most common source of itchies, allergies have many possible treatments. The most commonly applied versions are those that interfere with or mitigate the effects of the immune system––usually through drugs. 

Corticosteroids (like the ubiquitous prednisone pill or the injectable, long-acting Depo Medrol), cyclosporine (marketed as Atopica) and antihistamines (like Zyrtec, Benadryl and hydroxyzine) are by far the most common approaches. They come as pills, shots, sprays, creams, drops and shampoos––and they all have side effects.

Corticosteroids top the list for side effects, which is why we hate using them––unless we have to. They also happen to be among the most effective options. That’s why we try to stick to topical forms that are less likely to affect the whole body, as when we treat “hot spots” and ears, even anal glands. 

Cyclosporine is another immune system-dampening drug we often use, most often as a caplet that goes by the name, Atopica. Because its side-effects are less than for corticosteroids, we tend to recommend our clients adopt this safer (though by no means risk-free) approach. 

Administered once a day or once every other day, this expensive option is usually too pricey for most of my big dog clients, but often accessibly priced for my littler ones. 

Antihistamines are the best well-known and safest of the allergy drug alternatives. They interfere with the histamine molecules that cause the itchiness in the skin. Benadryl, Zyrtec and hydroxyzine are the ones most commonly prescribed. Unfortunately, they happen to be not as effective as the steroids and cyclosporines of this world. 

Finally, my favorite choices: Allergy vaccines, supplements and dietary therapy. 

Therapeutic, novel protein or hydrolyzed protein diets are often prescribed for these pets. Read up on food trials and how these diets can work here.

By far the best studied supplement for pets with any skin disease––but especially itchy skin problems––is the lowly fatty acid. Get one that's specifically formulated for pet skin and you'll be giving all these other methods a real boost...naturally.

As to allergy vaccines, here’s another whole post for your review.

Any questions? 

Dr. Patty Khuly

is a small animal veterinarian in Miami, Florida where she practices medicine at Sunset Animal Clinic. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine and The Wharton School of Business.